Start over in a 4 year program or jump into a CA-1 spot?

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sawthelight

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Hi all. My previous posts' answers have been great (I'm a categorical gen surg intern who's going to switch to anesthesia). It seems that I have two very valid options to choose from, just thought I'd pick the forum's collective brain.

I have been told, before formal applications have been sent in, that I have a very good if not nearly guaranteed chance at a 2010 CA-1 spot at a big name, big city, not so family-friendly program and also another spot at a smaller name and smaller city, more 1-on-1 training while still family friendly PGY-1/4 year program through the match. I'm much more inclinced at the type of training offered by the PGY-1 spot (plus it has a better call schedule and hours), but am not so excited about repeating that first year or going through the match. I'm pretty sure the training will be equivalent if not better at the smaller program, but it doesn't have a big name. I also am married with kids. Any thoughts?
 
Go to the more family-friendly program. Just think of it as fulfilling the same 5 years you thought you were signing up for with surgery.

I can tell you, I am at a family-friendly program, and it can be tough with kids. I can't imagine surviving with my family intact at a not-so-friendly program.
 
Having to tempt fate through the match changes things. You can either have a 100% sure bet out of match, starting next year, or potentially a 0% left-up-to-the-match option. I personally would go with the sure bet. Or, at least use that to negotiate an out of match spot at the 1-4 place.
 
I'm in your situation and just got a spot recently. I signed the contract ASAP just because I wanted to have a spot and be done with the process. For me, it being a sure thing was important. It didn't hurt that it is an amazing program in the area I want to live, but yeah. For those of us looking to switch, if you're happy with a program that offers you a spot, why chance it by turning it down?

I was in the great position of being offered a spot at my first choice program right off the bat, so I didn't have to make any difficult decisions about "take a spot or wait for something better," because there isn't anything better, at least not for my situation. I appreciate it can be hard. I also think that if you want anesthesia badly enough you should take what's offered to you and make it work as opposed to re-matching, but that's just my own dislike of the entire process coming through, as well.

good luck!!
 
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